Provider Demographics
NPI:1548277692
Name:MACQUARRIE, MICHAEL BRUCE (MD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:BRUCE
Last Name:MACQUARRIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 805
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959
Mailing Address - Country:US
Mailing Address - Phone:530-271-3232
Mailing Address - Fax:530-271-3239
Practice Address - Street 1:10121 PINE AVE
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96160
Practice Address - Country:US
Practice Address - Phone:530-582-3220
Practice Address - Fax:530-587-6123
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG23578207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G235780Medicaid
CAG23578OtherMEDICARE
CAG23578OtherMEDICARE
NVV35475Medicare ID - Type Unspecified